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Cardiometabolic determinants of early and advanced brain alterations: Insights from conventional and novel MRI techniques. Neurosci Biobehav Rev 2020; 115:308-320. [DOI: 10.1016/j.neubiorev.2020.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/21/2020] [Accepted: 04/02/2020] [Indexed: 12/11/2022]
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Nam KW, Kwon H, Kwon HM, Park JH, Jeong HY, Kim SH, Jeong SM, Kim HJ, Hwang SS. Abdominal fatness and cerebral white matter hyperintensity. J Neurol Sci 2019; 404:52-57. [PMID: 31326687 DOI: 10.1016/j.jns.2019.07.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 07/01/2019] [Accepted: 07/11/2019] [Indexed: 01/10/2023]
Abstract
Although obesity has been proven as a risk factor of metabolic and cardiovascular diseases, there have been few studies addressing the association between obesity and cerebral white matter hyperintensity (WMH) volume with controversial findings. In this study, we evaluated the relationship between abdominal fat distribution and WMH volume in a neurologically healthy population. We performed an observational study in a consecutive series of subjects who were examined during voluntary health check-ups between January 2006 and December 2013. We directly measured both visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) using abdominal computed tomography. The WMH volumes were also recorded quantitatively. A total of 2504 subjects were included in this study. In multivariate analysis, the relationship between SAT and WMH volume remained significant (β = -0.170, standard error [SE] = 0.065, P = .006) after adjusting for confounding factors. The protective effects of SAT on the WMH volume were more prominent in female participants (β = -0.295, SE = 0.138, P = .033) and in severely obese participants (β = -0.358, SE = 0.167, P = .033). Conclusively, we demonstrated a negative association between SAT and WMH volume in a healthy population.
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Affiliation(s)
- Ki-Woong Nam
- Department of Neurology, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, South Korea
| | - Hyuktae Kwon
- Department of Family Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, South Korea
| | - Hyung-Min Kwon
- Department of Neurology, Seoul National University College of Medicine and Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea.
| | - Jin-Ho Park
- Department of Family Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, South Korea.
| | - Han-Yeong Jeong
- Department of Neurology, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, South Korea
| | - Sang Hyuck Kim
- Department of Family Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, South Korea
| | - Su-Min Jeong
- Department of Family Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, South Korea
| | - Hwa Jung Kim
- Department of Clinical Epidemiology and Biostatics, ASAN Medical Center, Seoul, South Korea
| | - Seung-Sik Hwang
- Department of Public Health Sciences, Seoul National University Graduate School of Public Health, Seoul, South Korea
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Shin JA, Jeong SI, Kim M, Yoon JC, Kim HS, Park EM. Visceral adipose tissue inflammation is associated with age-related brain changes and ischemic brain damage in aged mice. Brain Behav Immun 2015; 50:221-231. [PMID: 26184082 DOI: 10.1016/j.bbi.2015.07.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 06/26/2015] [Accepted: 07/12/2015] [Indexed: 01/22/2023] Open
Abstract
Visceral adipose tissue is accumulated with aging. An increase in visceral fat accompanied by low-grade inflammation is associated with several adult-onset diseases. However, the effects of visceral adipose tissue inflammation on the normal and ischemic brains of aged are not clearly defined. To examine the role of visceral adipose tissue inflammation, we evaluated inflammatory cytokines in the serum, visceral adipose tissue, and brain as well as blood-brain barrier (BBB) permeability in aged male mice (20 months) underwent sham or visceral fat removal surgery compared with the young mice (2.5 months). Additionally, ischemic brain injury was compared in young and aged mice with sham and visceral fat removal surgery. Interleukin (IL)-1β, IL-6, and tumor necrosis factor-α levels in examined organs were increased in aged mice compared with the young mice, and these levels were reduced in the mice with visceral fat removal. Increased BBB permeability with reduced expression of tight junction proteins in aged sham mice were also decreased in mice with visceral fat removal. After focal ischemic injury, aged mice with visceral fat removal showed a reduction in infarct volumes, BBB permeability, and levels of proinflammatory cytokines in the ischemic brain compared with sham mice, although the neurological outcomes were not significantly improved. In addition, further upregulated visceral adipose tissue inflammation in response to ischemic brain injury was attenuated in mice with visceral fat removal. These results suggest that visceral adipose tissue inflammation is associated with age-related changes in the brain and contributes to the ischemic brain damage in the aged mice. We suggest that visceral adiposity should be considered as a factor affecting brain health and ischemic brain damage in the aged population.
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Affiliation(s)
- Jin A Shin
- Department of Pharmacology, School of Medicine, Ewha Womans University, Seoul 158-710, Republic of Korea; Tissue Injury Defense Research Center, School of Medicine, Ewha Womans University, 158-710, Republic of Korea
| | - Sae Im Jeong
- Department of Pharmacology, School of Medicine, Ewha Womans University, Seoul 158-710, Republic of Korea; Tissue Injury Defense Research Center, School of Medicine, Ewha Womans University, 158-710, Republic of Korea
| | - Minsuk Kim
- Department of Pharmacology, School of Medicine, Ewha Womans University, Seoul 158-710, Republic of Korea
| | - Joo Chun Yoon
- Tissue Injury Defense Research Center, School of Medicine, Ewha Womans University, 158-710, Republic of Korea; Department of Microbiology, School of Medicine, Ewha Womans University, Seoul 158-710, Republic of Korea
| | - Hee-Sun Kim
- Tissue Injury Defense Research Center, School of Medicine, Ewha Womans University, 158-710, Republic of Korea; Department of Molecular Medicine, School of Medicine, Ewha Womans University, Seoul 158-710, Republic of Korea
| | - Eun-Mi Park
- Department of Pharmacology, School of Medicine, Ewha Womans University, Seoul 158-710, Republic of Korea; Tissue Injury Defense Research Center, School of Medicine, Ewha Womans University, 158-710, Republic of Korea.
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Yamashiro K, Tanaka R, Tanaka Y, Miyamoto N, Shimada Y, Ueno Y, Urabe T, Hattori N. Visceral fat accumulation is associated with cerebral small vessel disease. Eur J Neurol 2014; 21:667-73. [PMID: 24495037 DOI: 10.1111/ene.12374] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 12/27/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Obesity is associated with the risk of coronary artery disease and stroke. Visceral fat plays a significant role in the atherogenic effects of obesity. Whether visceral fat accumulation, as measured by computed tomography (CT), is an independent risk factor for the presence of cerebral small vessel disease (SVD) was investigated. METHODS This study comprised 506 Japanese subjects 35-74 years of age (mean 55.3 years) without a history of symptomatic cerebrovascular disease who underwent health screening tests, including brain magnetic resonance imaging, carotid echography and measurements of the visceral fat area (VFA) and subcutaneous fat area (SFA) on abdominal CT. Visceral fat accumulation was defined as VFA ≥ 100 cm(2) . Logistic regression analysis was performed to examine the associations between visceral fat accumulation and cerebral SVD such as white matter lesions (WMLs) and silent lacunar infarction (SLI). RESULTS The prevalence of WMLs and SLI but not carotid plaque were significantly higher in subjects with VFA ≥ 100 cm(2) than those with VFA < 100 cm(2) . A VFA ≥ 100 cm(2) was associated with WMLs and SLI independent of age, cardiovascular risk factors and other measurements of obesity, such as waist circumference and body mass index. A large waist circumference was independently associated with SLI. SFA, the combination of VFA and SFA, and body mass index were not associated with WMLs or SLI. CONCLUSIONS Visceral fat accumulation was independently associated with the presence of cerebral SVD in subjects without a history of symptomatic cerebrovascular disease.
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Affiliation(s)
- K Yamashiro
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
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Taguchi A, Miki M, Muto A, Kubokawa K, Migita K, Higashi Y, Yoshinari N. Association between oral health and the risk of lacunar infarction in Japanese adults. Gerontology 2013; 59:499-506. [PMID: 23942139 DOI: 10.1159/000353707] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 06/10/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Poor oral health is associated with an increased risk of dementia in the elderly. One possible pathway linking these two phenomena is lacunar infarction, a potential cause of dementia. An association between poor oral health and an increased risk of ischaemic stroke has been recognised through the oral infection-inflammation pathway. However, little is known about whether poor oral health is associated with the progression of lacunar infarction. OBJECTIVE We examined the association between variables related to oral health and lacunar infarction, as detected by magnetic resonance imaging (MRI). METHODS A total of 110 subjects (52 men, 58 women), aged 27-76 years, who visited our periodontology clinic participated in this study. The subjects underwent dental radiography, periodontal examinations and brain MRI. One experienced specialist in cardiovascular disease and one experienced neurosurgeon determined the number of lacunar infarctions on brain MRI. Periodontologists performed clinical periodontal examinations. Variables related to oral health were determined from the radiographs by an oral radiologist. Information on the subjects' lifestyles and disease histories were obtained using a structured questionnaire and confirmed by clinical records. Adjacent categories logit regression analysis with backward elimination was used to determine variables associated with three groups based on the number of lacunar infarctions. RESULTS Of the 110 subjects, 61 had lacunar infarctions. Nineteen had multiple (≥7) lesions. Aging (p = 0.0004), increased time spent in physical activity per day (p = 0.042), the presence of hypertension (p = 0.006), the absence of hyperlipidaemia (p = 0.045), the presence of diabetes mellitus (p = 0.025) and low alveolar bone height (p = 0.026) were significantly associated with an increased number of lacunar infarctions in the final regression model. The significance of hyperlipidaemia and alveolar bone height disappeared in an unadjusted model. An increased pocket depth, which indicates current periodontal disease progression, tended to be associated with an increased number of lacunar infarctions (p = 0.058). This tendency did not disappear in an unadjusted model. CONCLUSION Our results suggest that lacunar infarction may be associated with current periodontal disease in Japanese adults.
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Affiliation(s)
- Akira Taguchi
- Department of Oral and Maxillofacial Radiology, Matsumoto Dental University, Shiojiri, Japan
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Increased oxidative stress in epileptic children treated with valproic acid. Epilepsy Res 2008; 78:171-7. [DOI: 10.1016/j.eplepsyres.2007.11.005] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2007] [Revised: 11/13/2007] [Accepted: 11/18/2007] [Indexed: 01/11/2023]
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Jeong JW, Jeong MH, Yun KH, Oh SK, Park EM, Kim YK, Rhee SJ, Lee EM, Lee J, Yoo NJ, Kim NH, Park JC. Echocardiographic epicardial fat thickness and coronary artery disease. Circ J 2007; 71:536-9. [PMID: 17384455 DOI: 10.1253/circj.71.536] [Citation(s) in RCA: 271] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The association between epicardial fat and coronary artery disease has not been evaluated. The objective of the present study was to evaluate the relationship of echocardiographic epicardial fat to the presence and severity of coronary artery disease in a clinical setting. METHODS AND RESULTS Two hundred and three consecutive patients who underwent echocardiography and diagnostic coronary angiography were studied. The epicardial fat thickness on the free wall of the right ventricle was measured at end-diastole from the parasternal long-axis views of 3 cardiac cycles. Coronary angiograms were analyzed for the extent and severity of coronary artery disease using Gensini's score. The patients were divided into 2 groups according to the fourth quartile of epicardial fat thickness (Group I <7.6 mm; Group II > or =7.6 mm). There were no significant differences in the baseline characteristics except for waist circumference (p=0.023). Significant correlations were demonstrated between epicardial fat thickness and age (r=0.332, p<0.001), C-reactive protein (r=0.182, p=0.009), body mass index (r=0.142, p=0.044) and waist circumference (r=0.229, p=0.001). The patients with a higher epicardial fat thickness were associated with a high Gensini's score (p=0.014). Multivariate analysis showed that age (odds ratio (OR) 5.29, p=0.003), epicardial fat thickness (OR 10.53, p=0.004), diabetes (OR 8.06, p=0.006) and smoking (OR 14.65, p=0.015) were independent factors affecting significant coronary artery stenosis. CONCLUSIONS Epicardial fat thickness was significantly correlated with the severity of coronary artery disease in patients with known coronary artery disease.
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Affiliation(s)
- Jin-Won Jeong
- Departments of Cardiovascular Medicine, Wonkwang University Hospital, Iksan, Korea
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Fujita K, Nishizawa H, Funahashi T, Shimomura I, Shimabukuro M. Systemic oxidative stress is associated with visceral fat accumulation and the metabolic syndrome. Circ J 2006; 70:1437-42. [PMID: 17062967 DOI: 10.1253/circj.70.1437] [Citation(s) in RCA: 217] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The metabolic syndrome (MetS) is a major target for prevention of atherosclerotic cardiovascular diseases and visceral fat accumulation is an underlying component of MetS. The aim of this study was to investigate the association of systemic oxidative stress with visceral fat accumulation and MetS. METHODS AND RESULTS The study group consisted of Japanese men (n=44; 51.2+/-11.4 years) and women (n=61; 55.4 +/-13.4 years). Urinary 8-epi-prostaglandin F2alpha (8-epi-PGF2 alpha) concentration, a biomarker of systemic oxidative stress, was significantly high in the subjects with MetS. As the urinary concentration of 8-epi-PGF2alpha increased, the number of criteria for MetS were significantly met (abdominal obesity, hypertriglyceridemia, low high-density lipoprotein-cholesterol, hypertension, and high fasting glucose). Among parameters associated with MetS, the correlation coefficient of visceral fat area (VFA) with urinary 8-epi-PGF2alpha concentration was the highest (r=0.636, p<0.0001). In non-obese subjects, the correlation coefficient of VFA with urinary 8-epi-PGF2alpha concentration was higher (r=0.728, p<0.0001), although there was no significant correlation between subcutaneous fat area and urinary 8-epi-PGF2 alpha. Stepwise multiple regression analysis identified VFA as the strongest and independent determinant of urinary 8-epi-PGF2 alpha (p<0.0001) followed by adiponectin (p=0.0212) and, high sensitive C-reactive protein (p=0.0365). CONCLUSIONS Systemic oxidative stress, as measured by urinary 8-epi-PGF2alpha , is strongly associated with visceral fat accumulation and MetS.
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Affiliation(s)
- Koichi Fujita
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
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Inoue T, Kobayashi M, Uetsuka Y, Uchiyama S. Pharmacoeconomic Analysis of Cilostazol for the Secondary Prevention of Cerebral Infarction. Circ J 2006; 70:453-8. [PMID: 16565564 DOI: 10.1253/circj.70.453] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The antiplatelet agent, cilostazol, is known to reduce the risk of subsequent cerebral infarction. However, the cost effectiveness of such treatment in comparison to aspirin has not been studied. METHODS AND RESULTS A Markov model was developed to calculate the health outcomes and associated costs for 65-year-old patients with cerebral infarction who were treated with 200 mg/day cilostazol or 81 mg/day aspirin. Cilostazol was more effective, but also more expensive than aspirin. Cilostazol would extend quality-adjusted life years (QALY) by 0.64, while increasing life-time costs by approximately Yen 1.1 million. The incremental cost-effectiveness ratio of cilostazol in comparison with aspirin was estimated to be Yen 1.8 million per QALY. CONCLUSIONS The use of cilostazol to prevent recurrence of cerebral infarction appears to be cost effective.
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Affiliation(s)
- Tadao Inoue
- Department of Pharmacy, St. Luke's International Hospital, Tokyo, Japan.
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Kotani K, Osaki Y, Sakane N. Relationship Between Abdominal Visceral Fat and Lacunar Infarcts in Japanese Men. Circ J 2005; 69:373. [PMID: 15756746 DOI: 10.1253/circj.69.373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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